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Sepsis is a complex condition of inflammatory and immune dysregulation, triggered by severe infection. In survivors, chronic inflammation and immune dysregulation linger, facilitating the emergence of infections. CD8 dysfunction contributes to immunosuppression in sepsis survivors. We devised an animal model that enabled us to identify and analyze CD8-intrinsic defects induced by sepsis. We adoptively transferred CD45.1 CD8 OT-I T cells into CD45.2 congenic mice and subjected them to cecal ligature and puncture, to induce abdominal sepsis. One month later, we isolated the transferred CD8 cells. Surface marker expression confirmed they had not been activated through the TCR. CD8 OT-I T cells isolated from septic (or sham-operated) mice were transferred to second recipients, which were challenged with OVA-expressing Listeria monocytogenes. We compared effector capacities between OT-I cells exposed to sepsis and control cells. Naive mice that received OT-I cells exposed to sepsis had higher bacterial burden and a shorter survival when challenged with OVA-expressing L. monocytogenes. OT-I cells isolated from septic mice produced less IFN-γ but had conserved activation, expansion potential, and cytotoxic function. We observed lower transcript levels of IFN-γ and of the long noncoding RNA Ifng-as1, a local regulator of the epigenetic landscape, in cells exposed to sepsis. Accordingly, local abundance of a histone modification characteristic of active promoter regions was reduced in sepsis-exposed CD8 T cells. Our results identify a mechanism through which inflammation in the context of sepsis affects CD8 T cell function intrinsically.

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This study evaluated the effects of in-the-bag dry-ageing on eating quality and volatile compounds of longissimus lumborum from cows and steers. Compared to wet-ageing, in-the-bag dry-ageing increased purge loss (P < 0.0001), cooking time (P < 0.0001), salty taste (P < 0.05) and sour-dairy flavour (P < 0.01), whereas decreased cooking loss (P < 0.0001), amount of perceptible connective tissue (P < 0.05) and livery flavour (P < 0.05) in both cow and steer meat. This dry-ageing technology also increased juiciness (P < 0.01) and brown-roasted aroma (P < 0.05) in steer meat, whereas decreased the juiciness (P < 0.01) of cow meat. Regardless of the ageing method, cow meat was tougher (P < 0.0001), less juicy (P < 0.001) and sweeter (P < 0.05) and presented higher amount of perceived connective tissue (P < 0.0001) than steer meat, whereas steer meat had higher ratings for beef (P < 0.05) and brown-roasted (P < 0.01) flavours. Volatile compounds were largely affected (P < 0.05) by animal-type, most of them being higher in cow than steer meat. In contrast, in-the-bag dry-ageing affected a few volatile compounds such as alcohols, aldehydes and ketones.

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PURPOSE: To describe the implementation of a postfracture care program in a private hospital in Colombia, the results achieved after the program's first year, and the challenges encountered. METHODS: A cross-sectional descriptive study of the first year's outcomes. The program was implemented following best practices described in the "Capture the Fracture" framework. We assessed the management of fractures before the launch of the program. A multidisciplinary group was established to collaborate on the diagnosis and treatment of patients with osteoporotic fractures. A full-time program coordinator was appointed. We analyzed the program's clinical outcomes and limitations. RESULTS: One-hundred and ninety patients were included in the study, with an average age of 76.7. Hip fracture was the most frequent one (33.6%). After the first year of implementing the program, 39.4% of patients received osteoporosis treatment, with an adherence rate of 73%. The incidence of subsequent falls was 5.8% and 1% for new fractures. CONCLUSIONS: The implementation of a program for patients' care with fragility fractures is challenging for healthcare institutions. The role of a full-time coordinator is critical for the proper operation of such programs.

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How T cells integrate environmental cues into signals that limit the magnitude and length of immune responses is poorly understood. Here, we provide data that demonstrate that B55ß, a regulatory subunit of protein phosphatase 2A, represents a molecular link between cytokine concentration and apoptosis in activated CD8+ T cells. Through the modulation of AKT, B55ß induced the expression of the proapoptotic molecule Hrk in response to cytokine withdrawal. Accordingly, B55ß and Hrk were both required for in vivo and in vitro contraction of activated CD8+ lymphocytes. We show that this process plays a role during clonal contraction, establishment of immune memory, and preservation of peripheral tolerance. This regulatory pathway may represent an unexplored opportunity to end unwanted immune responses or to promote immune memory.

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The original version of this article unfortunately contained an error in the spelling of the last name of one of the co-authors. The corresponding author did not notice that the last name of one of the co-authors, Nathan Shlobin, was misspelled as "Schlobin". The correct spelling of his last name is "Shlobin". Given in this article is the corrected author name.

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Stingray injuries are rare, mostly causing injuries to the lower extremities but occasionally fatal if there is direct puncture of the thorax, abdomen, or neck. Direct combined stingray injury to the central nervous system has not been reported in the literature. Herein we present the case of a 12-year-old boy who, while wading at the seashore of the Costa Rica's Pacific Ocean, sustained a combined oblique penetrating injury to the C6 vertebra caused by a Stingray. He initially presented to the hospital with a complete asymmetric right C6/left T1 ASIA A examination, priapism, and loss of anal sphincter tone. Imaging revealed fracture of the posterior elements of C6 with an oblique trajectory into the left radicular foramen. T2W images did not reveal anatomical section but rather edema and minor bleeding in the epidural space. The patient underwent medical management and serial imaging. During the next 3 months, there was recovery of sensation on the right hemi body, bilateral paresthesias and asymmetric progressive improvement in strength on both legs. Acute care management and midterm term follow up are provided, along with a review of the literature for salient management considerations when evaluating and treating combined penetrating and envenomation injuries caused by stingrays. To our knowledge, this is the first report of such injury to the spine.

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BACKGROUND: The biology of the skin is very complex, and there are a number of methods used to classify the different skin types. It is possible to measure or quantify the characteristics of the specific skin types, using a variety of techniques that can objectively evaluate the properties of the skin in a noninvasive manner. AIM: To clinically characterize different skin types by dermatological evaluation and biophysical and skin imaging techniques, and to evaluate the relationship between the different characteristics. METHODS: The study recruited 26 volunteers. Clinical scoring was performed by a dermatologist who classified the volunteers' skin as normal or dry (group 1) and combination or oily (group 2). Objective measurements included skin microrelief, pH, oiliness, water content of the stratum corneum and transepidermal water loss (TEWL). RESULTS: Positive correlations were found between the level of skin oiliness and skin texture obtained from both instrumental analysis and clinical scoring. The combination and oily skin types had higher clinical scores for shine intensity, oiliness and tendency to pigmentation, and also had higher objective scores for sebum secretion, TEWL and roughness. CONCLUSIONS: Biophysical and skin imaging techniques are effective tools to help characterize skin type and assist in clinical dermatology. We found that different skin types had different characteristics related to skin microrelief, oiliness and TEWL, and therefore require specific dermatological treatments.

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We conducted an ambispective cohort study of 83 patients with a diagnosis of Lisfranc fracture dislocation from 1993 to 2008. The lesions were classified into two groups: pure dislocations and fracture dislocations of the Lisfranc joint using the Hardcastle-Reschamer classification. The results included the following data: sociodemographic and epidemiologic variables, lesion-related variables, clinical parameters, and the following clinical and functional assessment scales: Baltimore Painful Foot Score, Creighton-Nebraska Health Foundation, American Orthopaedic Foot and Ankle Society (AOFAS), and Hannover Scoring System. Sixty-three patients were treated surgically. Closed reduction and minimally invasive fixation with Kirschner nails were performed in 53 patients (63.9%), and open reduction with a dorsal approach and fixation with Kirschner nails in 10 cases (15.2%). In 46 cases de medial column was fixed, in 61 cases the intermediate column, and in 42 the lateral column. Sixty-six (79.5%) of the patients had complications including both acute and late ones. Regardless of the technique used, the purpose of treatment was the anatomical reduction of the involved joints. Based on our experience, we think that the use of Kirschner nails is effective, as it provides enough stiffness and stability. In general terms, this injury is not as disabling as it had been considered in the literature. Patients consider their discomfort as tolerable and compatible with the demands of their activities of daily living and they may perform their work considering the time limitations.

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INTRODUCTION: Improving the health care dispensed to patients who have suffered a cerebrovascular accident (CVA) requires a thorough knowledge of its evolution. AIMS: To examine the evolution of CVA and its subgroups by looking at the rates of mortality, recurrences and extra-neurological complications. We also sought to determine the value of different clinical scales and urinary incontinence at the beginning of CVA as factors that could potentially predict its severity. A third objective was to find out the time elapsed between the onset of CVA and the patient's contacting the medical team. PATIENTS AND METHODS: The study, which spanned the period between 1st March 2000 and 28th February 2002, was conducted in the town of Rivera, which has a population of 62 859 and is located in the north of the Eastern Republic of Uruguay. During the first year of the study, 79 patients with CVA were registered, each of whom was clinically monitored for a year. RESULTS: The mortality rate at one month was 24% and at one year rose to 38%. The validity of certain factors predicting mortality due to CVA was confirmed as a lower score on the Glasgow scale, a higher score on the NIH impairment scale, and the presence of urinary incontinence, haemorrhagic CVA and total anterior circulation syndrome. In 87.3% of cases the patient was attended within the first 24 hours. CONCLUSIONS: The findings of this study will make it possible to adopt health care strategies to improve the quality of medical attention, lower the mortality rate and prevent sequelae in CVA patients.

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The properties of 21 isolates ofPenicillium roqueforti from just as many commercial blue-veined cheeses, purchased from the Argentinean market (domestic and imported products) were comparatively examined. Isolates were investigated for their ability to grow at different temperatures, pH values and concentration of NaCl, as well as for their proteolytic and lipolytic activities, respectively. The potential of these strains to produce roquefortin in vitro, and the actual levels of roquefortin in 10 of these cheeses were analysed by TLC. All strains showed similar growth properties in aspects of salt concentration and pH-value of the medium, and all grew well at 10 °C. Only four strains showed proteolytic activity on casein agar, while all strains were lipolytic on trybutirin agar. After incubation at 25 °C for 16 days, all strains produced roquefortin in Yeast Extract Sucrose (25.6-426.7 µg/g) and in reconstituted (10%) sterile skim milk (26.9-488 µg/g). Roquefortin at >0.1 µg/g was also found in 9 out of 10 analysed samples of blue-veined cheeses (8 from Argentine, 1 from Spain), with a maximum value 3.6 µg/g. During the ripening process of blueveined cheese, production of roquefortin seems to be unavoidable. Care should be taken to select strains with low toxin production characteristics, to minimize potential health risks. Roquefortin C production byP. roqueforti in vitro was not correlated with roquefortin C levels found in cheese.

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INTRODUCTION: Knowledge about the epidemiology of cerebrovascular accidents (CVA), or stroke, in the town of Rivera, Uruguay, would be useful as the basis on which to apply health care strategies both in the prevention of risk factors and in early diagnosis and treatment. AIMS: To determine the incidence of CVA in the town of Rivera and to study the association between certain risk factors and the pathological type of CVA. PATIENTS AND METHODS: The study, which spanned the period between 1st March 2000 and 28th February 2001, was conducted in the town of Rivera, which has a population of 62,859 and is located in the north of the Eastern Republic of Uruguay. The sample consisted of 114 patients with CVA, of whom 79 had no previous history of CVA -first CVA in lifetime (FCVAL)-. RESULTS AND CONCLUSIONS: The incidence of CVA was 181.3 cases per 100,000 inhabitants per year. The incidence of FCVAL was 125.7 cases per 100,000 inhabitants per year. 73.4% of the FCVAL were ischaemic and 26.6% were haemorrhagic. A high percentage of arterial hypertension was found in patients with CVA (84%) and with FCVAL (80.7%), and a statistically significant association was observed between congestive heart failure and ischaemic CVA.

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Objetivos: Determinar el tiempo empleado en el registro de datos en las consultas de los servicios de crecimiento y desarrollo en un centro de salud. Lugar: Centro de Salud Mi Perú, Dirección de Salud Callao, Perú. Materiales y Métodos: Estudio de tiempos, mediante observación directa, durante el proceso de atención a 51 usuarios en la consulta del Servicio de Crecimiento y Desarrollo. Resultados: Durante la atención a los usuarios del servicio de crecimiento y desarrollo, se usó 5 formatos para el registro de datos. Cada vez que un niño fue atendido, se registró 31 variables; una de ellas fue registrada simultáneamente en 5 formatos, 3 variables en 6 formatos y 7 en 2 formatos. La mediana de tiempo requerido para el registro manual de todos los formatos fue 2,09 minutos, equivalentes a 15,3 por ciento del tiempo total de atención a cada niño. Conclusión: El registro de datos en los servicios de crecimiento y desarrollo demanda una alta proporción del tiempo disponible para la atención a los usuarios.

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The objective was to evaluate the effect of cow genetic group, nutritional level and their interaction on some economically important traits of dual-purpose herds managed under field conditions. Nine herds were monitored during a production cycle in Yucatan, Mexico. Herds were grouped into four nutritional levels (NL) based on the metabolizable energy (ME) apparently available on pasture, nutritional management, and milk production. Cows were classified into three genetic groups (GG): low (< or = 25%), middle (25-75%) and high (> or = 75%) graded for Bos taurus inheritance. Total milk sold (TMS), days in milk (DIM), TMS adjusted to DIM within each NL (TMSA), body condition score (BCS) at calving, changes of BCS during lactation (CBCS), calf weaning weight (WW), age at weaning (AW), kg of calf weaned per cow (KWC) and calf mortality were studied. The statistical model included the fixed effects of NL, GG, month of calving (MC), parity number (PN) and BCS at calving and GG x NL interaction. The effects of NL, GG, MC, PN and GG x NL were significant (p < 0.05) for TMS, KWC. As expected, TMS increased with NL from 562.4 +/- 106 kg for NL1 to 2366.3 +/- 100.1 kg for NL4. KWC was greatest for NL2 (138.6 kg) followed by NL1 (135 kg); the lowest KWC corresponded to NL4 (96.0 kg) (p < 0.05). TMS values for the middle (1727 +/- 94.7 kg) and the high graded GG (1603.5 +/- 83.5 kg) were twice those for the low graded GG cows (828.5 +/- 95 kg) (p < 0.05). KWC was also higher for the middle graded group (152.8 kg) than for the low or (104 kg) or the high graded GG (118 kg) (p < 0.05). With better nutrition cows of all GG improved their milk performance but not the calf traits. CBCS was negative for all GG. The highest BCS lost was for cows in NL1 and NL2 and for cows in the high graded GG (p < 0.05).

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Avaliou-se a distribuição de Lawsonia intracellularis em fezes de suínos, coletadas diretamente no reto, durante a fase de crescimento/terminação, sob condições de campo, e determinou-se o efeito da infecção L. intracellularis no ganho de peso. O estudo epidemiológico longitudinal foi desenvolvido em uma granja de múltiplos sítios em Yucatan, México. A granja possuía três sítios geograficamente isolados com o sistema "todos dentro todos fora". Uma amostra de 56 suínos negativos para a bactéria foi calculada utilizando prevalência esperada de 5%, nível de confiança de 95% e população de 2000 suínos terminados. Os suínos foram amostrados 12 vezes desde o nascimento até a 23ª semana de idade. A detecção de DNA bacteriano nas fezes pela técnica de reação em cadeia pela polimerase em qualquer coleta representou um caso. Dos 56 suínos monitorados, 13 eliminaram L. intracellularis nas fezes e somente um resultou positivo duas vezes. A eliminação de L. intracellularis foi detectada desde a terceira até a 19ª semana de idade, observando-se maior número de animais positivos na 11ª semana. A incidência acumulada e a taxa de incidência foram 23,2% e 1,21 suínos por 100 animais/semana em risco, respectivamente. As médias do ganho de peso por dia foram 0,742±0,06kg e 0,754±0,07kg para os suínos negativos e positivos, respectivamente (P>0,05). A eliminação da bactéria ocorreu durante todo o período de estudo. Pelo menos neste estudo, L. intracellularis não pode ser utilizado para predizer o efeito da bactéria sobre o ganho de peso.(AU)

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Avaliou-se a distribuição de Lawsonia intracellularis em fezes de suínos, coletadas diretamente no reto, durante a fase de crescimento/terminação, sob condições de campo, e determinou-se o efeito da infecção L. intracellularis no ganho de peso. O estudo epidemiológico longitudinal foi desenvolvido em uma granja de múltiplos sítios em Yucatan, México. A granja possuía três sítios geograficamente isolados com o sistema "todos dentro todos fora". Uma amostra de 56 suínos negativos para a bactéria foi calculada utilizando prevalência esperada de 5 por cento, nível de confiança de 95 por cento e população de 2000 suínos terminados. Os suínos foram amostrados 12 vezes desde o nascimento até a 23ª semana de idade. A detecção de DNA bacteriano nas fezes pela técnica de reação em cadeia pela polimerase em qualquer coleta representou um caso. Dos 56 suínos monitorados, 13 eliminaram L. intracellularis nas fezes e somente um resultou positivo duas vezes. A eliminação de L. intracellularis foi detectada desde a terceira até a 19ª semana de idade, observando-se maior número de animais positivos na 11ª semana. A incidência acumulada e a taxa de incidência foram 23,2 por cento e 1,21 suínos por 100 animais/semana em risco, respectivamente. As médias do ganho de peso por dia foram 0,742±0,06kg e 0,754±0,07kg para os suínos negativos e positivos, respectivamente (P>0,05). A eliminação da bactéria ocorreu durante todo o período de estudo. Pelo menos neste estudo, L. intracellularis não pode ser utilizado para predizer o efeito da bactéria sobre o ganho de peso.

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INTRODUCTION AND AIMS: Influenced by medical, scientific and social advances, the changes that have taken place in the needs of the population have given rise to a growing demand for health care in neuropaediatric pathology. The aim of this study was to determine the neuropaediatric health care requirements at the Hospital General Universitario de Guadalajara, a secondary care hospital that is a reference centre for the province of Guadalajara. PATIENTS AND METHODS: We studied the children up to the age of 10 years with a neurological pathology attended at the Hospital General Universitario de Guadalajara over an 8-year period, since the Neuropaediatric unit was opened on 1 July 1992. RESULTS: In all 1,236 children were evaluated, which represents 8.45% of all the children below the age of 10 in the province of Guadalajara, with an average of 154.5 new patients per year. There was a predominance of males, 56.4%, and a high percentage of very young children: 26.05% under the age of 1 year and 50.56% under the age of 3. There has been a progressive increase in the number of Neuropaediatric outpatients, which in the year 2000 accounted for 20% of first visits and 16% of the total number (first and successive) of Paediatric outpatients. 12.94% of the patients in our series had also been examined in different tertiary care hospitals. CONCLUSIONS: There is a very high demand for neuropaediatric care in Guadalajara and it is growing in a significant and progressive manner. We suggest it would be advisable to have a tertiary reference hospital available to help cope with this situation.

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A survey on 28 samples of Blackmold" affected tomatoes cultivated in Argentina was made.A. alternata was the most frequently occurring species.A. tenuissima, A. longipes yUdocladium spp. were also isolated. All theAlternaria strains (25) were able to produce mycotoxins, including Alternariol, Alternariol Monomethyl Ether and Tenuazonic Acid, on autoclaved rice (at 25°C and 8°C) and in fresh surface disinfected tomatoes at 25°C.

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Information on 936 birth weights (BW), adjusted weaning weights (AWW) and average daily gains (ADG) from Brahman (B), Indubrazil (I), Gyr (G) and commercial Zebu (C) cattle and their crosses were obtained from the records of a farm in the State of Yucatan, Mexico. Two statistical models were used to analyse the data: the first included the effects of year and season of birth, sex of the calf, cow's parity number and breed group. The other model included the same environmental effects as the previous model and the genetic components of breed group (breed additive, breed maternal and heterosis effects). Additive and maternal effects were expressed as deviations from those for the B breed. The means of BW. AWW and ADG for the B breed were 33.3 +/- 0.64 kg, 204.0 +/- 4.9 kg and 760.06 +/- 19.24 g/day, respectively. Both models gave similar results in terms of the variance explained. Additive effects were significant (p < 0.05) for AWW and ADG but not for BW. The minor additive effect was for the C breed (-10.75 kg and 40.77 g for WW and ADG, respectively). Maternal and heterosis effects were not significant (p > 0.05) for any of the traits. The correlation between the breed group means and the means estimated by the prediction equation was r = 0.88. Finally, there was no significant genetic effect on pre-weaning calf performance among the genotypes evaluated. The genetic model can be used to predict the genotype means with a high degree of accuracy.

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Liver cirrhosis represents a worldwide health problem and is a major cause of mortality. Cirrhosis is the result of extensive hepatocyte death and fibrosis induced by chronic alcohol abuse and hepatitis B and C viruses. Successful gene therapy approaches to this disease may require both reversal of fibrosis and stimulation of hepatocyte growth. Urokinase-type plasminogen activator (uPA) may serve this function, as it is an initiator of the matrix proteolysis cascade and induces hepatocyte growth factor expression. In a rat cirrhosis model, a single iv administration of a replication-deficient adenoviral vector encoding a nonsecreted form of human uPA resulted in high production of functional uPA protein in the liver. This led to induction of collagenase expression and reversal of fibrosis with concomitant hepatocyte and improved liver function. Thus, uPA gene therapy may be an effective strategy for treating cirrhosis in humans.

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